Psychological and emotional needs, assessment, and support post-stroke: a multi-perspective qualitative study
Psychological and emotional needs, assessment, and support post-stroke: a multi-perspective qualitative study
复制标题
DOI：
10.1080/10749357.2016.1196908
复制
发表时间：
2017-01-01
影响因子：
2.2
通讯作者：
Jones, Amanda
中科院分区：
文献类型：
--
作者：
Harrison, Madeleine;Ryan, Tony;Jones, Amanda
背景：国际脑卒中护理指南推荐对脑卒中后的心理和情绪问题进行常规评估和管理。了解提供和接受这些服务的人的经历对于改善中风后心理支持的提供至关重要。目的：探讨脑卒中患者、护理人员和卫生专业人员在住院和出院后的心理需求、评估和支持方面的经历。方法：参与者从英格兰北部的七家中风专科医院招募。对31名中风患者、28名护理人员和66名卫生专业人员进行了定性半结构化访谈和焦点小组。访谈被逐字记录和转录，并使用专题分析进行分析。结果：出现了两个中心主题：心理专业知识，以及被认为减少对正式心理支持需求的保护因素。在中风单位工作的医疗保健专业人员中缺乏心理学专业知识是令人沮丧的根源，并导致其他学科承担了没有所需技能和培训的心理学家的角色。多个利益相关者讨论了保护性因素的重要性，包括向下社会比较、社会支持、同伴支持、沟通和信息提供，这些因素被认为可以减少对正式心理支持的需求。讨论：中风患者需要更好地获得心理支持，包括信息、建议、同伴或社会支持。需要更多的研究来确定正式心理支持的替代方案的有效性。
Background: International stroke care guidelines recommend the routine assessment and management of psychological and emotional problems post-stroke. Understanding the experiences of those delivering and receiving these services is vital to improving the provision of psychological support post-stroke.Objectives: To explore patients', carers', and health professionals' experiences of psychological need, assessment, and support post-stroke while in hospital and immediately post-discharge.Methods: Participants were recruited from seven specialist stroke services in the north of England. Qualitative semi-structured interviews and focus groups were conducted with 31 stroke patients, 28 carers, and 66 health professionals. The interviews were recorded and transcribed verbatim and analyzed using thematic analysis.Results: Two central themes emerged minding the gap: psychological expertise, and protective factors perceived to reduce the need for formal psychological support. The lack of psychological expertise among healthcare professionals working on stroke units was a source of frustration and resulted in other disciplines assuming the role of a psychologist without the required skills and training. Multiple stakeholders discussed the importance of protective factors, including downward social comparison, social support, peer support, communication, and information provision, that were perceived to reduce the need for formal psychological support.Discussion: Stroke patients need better access to psychological support, including information, advice, and peer or social support. More research is required to establish the effectiveness of alternative options to formal psychological support.